I am a 27 year old gay male. I have just met a guy who is negative. I told him of my status on the upfront and he is accepting. He wanted to have intercourse with me using a condom but he changed his mind and went without one anyway. I told him it bothers me he doesn't want to use a condom but that is his decision.. he is a top and of course doesn't want me to top him with or without a condom... but I really like him and don't want anything bad to happen.. How should I handle this situation? How much is he at risk being a top unprotected?

Response from Dr. Remien

I am not going to get into the details about level of risk, because I imagine you already know the answer: while it is less risky as a "top" than it is as a "bottom," there is still risk for the transmission of HIV, as well as other STDs. And this includes the risk of other STDs to you, something you don't want to have if you are living with HIV. And I don't agree with you when you say that it is "his decision." What level of risk you and your partner are willing to live with is ultimately up to BOTH of you.

I actually think that your issues are more about respect and boundaries between the two of you. While it is challenging to negotiate such matters, it will be important for the two of you to discuss all of your feelings, about sex and risk, openly and honestly. This is still a new and developing relationship for you. I wonder what having unprotected sex really means to you. And if, as you say, you feel uncomfortable having unprotected sex, what is the message from your boyfriend if he still insists on it? That doesn't seem very respectful of you and your feelings. How WOULD you feel if he were to become infected with HIV?

Again, you are dealing with issues that require honest, open, and respectful discussion between the two of you. And if you really do have specific questions about risk, please submit your questions to The Body's Safe Sex and HIV Prevention Forum

This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither TheBody.com nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

The Body is a service of Remedy Health Media, LLC, 750 3rd Avenue, 6th Floor, New York, NY 10017. The Body and its logos are trademarks of Remedy Health Media, LLC, and its subsidiaries, which owns the copyright of The Body's homepage, topic pages, page designs and HTML code. General Disclaimer: The Body is designed for educational purposes only and is not engaged in rendering medical advice or professional services. The information provided through The Body should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. If you have or suspect you may have a health problem, consult your health care provider.